From a vial of mom's blood, a fetus's entire genome

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Puerto Rico sees sharp spike in dengue cases

The number of detected dengue cases is running at above-average levels as Puerto Rico enters the peak season for the painful disease.

The territory's Health Secretary Lorenzo Gonzalez says 111 cases were reported the first week of June and 117 cases the previous week. Eight cases of the more-severe hemorrhagic form have been confirmed, though no one has died.

A U.S. Centers for Disease Control report shows new infections running at a pace that has marked past epidemics. Dengue cases usually peak in early October.

Gonzalez said late Tuesday that detected cases may be rising because of new courses to help doctors identify symptoms.

The mosquito-borne virus causes fever, severe headaches and extreme joint and muscle pain.

Dengue claimed a record 31 lives in Puerto Rico during a 2010 epidemic.

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India to give free generic drugs to hundreds of millions

Reuters – 6 hrs ago MUMBAI (Reuters) - India has put in place a $5.4 billion policy to provide free medicine to its people, a decision that could change the lives of hundreds of millions, but a ban on branded drugs stands to cut Big Pharma out of the windfall.

From city hospitals to tiny rural clinics, India's public doctors will soon be able to prescribe free generic drugs to all comers, vastly expanding access to medicine in a country where public spending on health was just $4.50 per person last year.

The plan was quietly adopted last year but not publicized. Initial funding has been allocated in recent weeks, officials said.

Under the plan, doctors will be limited to a generics-only drug list and face punishment for prescribing branded medicines, a major disadvantage for pharmaceutical giants in one of the world's fastest-growing drug markets.

"Without a doubt, it is a considerable blow to an already beleaguered industry, recently the subject of several disadvantageous decisions in India," said KPMG partner Chris Stirling, who is European head of Chemicals and Pharmaceuticals.

"Pharmaceutical firms will likely rethink their emerging markets strategies carefully to take account of this development, and any similar copycat moves across other geographies," he added.

But the initiative would overhaul a system where healthcare is often a luxury and private clinics account for four times as much spending as state hospitals, despite 40 percent of the people living below the poverty line, or $1.25 a day or less.

Within five years, up to half of India's 1.2 billion people are likely to take advantage of the scheme, the government says. Others are likely to continue visiting private hospitals and clinics, where the scheme will not operate.

"The policy of the government is to promote greater and rational use of generic medicines that are of standard quality," said L.C. Goyal, additional secretary at India's Ministry of Health and Family Welfare and a key proponent of the policy.

"They are much, much cheaper than the branded ones."

Global drugmakers like Pfizer, GlaxoSmithKline and Merck will be hit. They spend billions of dollars a year researching new treatments and target huge growth for branded medicine in emerging economies such as India, where generics account for around 90 percent of drug sales by value, far more than in developed countries.

U.S.-based Abbott Laboratories, which bought an Indian generics maker in 2010, is the biggest seller of drugs, both branded and generic, in India, followed by GlaxoSmithKline.

BIG PHARMA BLUES

In March, India granted its first ever compulsory license, allowing a domestic drugmaker to manufacture a copy-cat version of Nexavar, a cancer drug developed by Germany's Bayer, unnerving foreign drugmakers that fear a lack of intellectual property protection in emerging markets.

That enabled India's Natco Pharma to sell its generic version of Nexavar at 8,800 rupees ($160) per monthly dose, a fraction of the 280,000 rupees Bayer's version cost.

In another blow to Big Pharma's emerging market ambitions, China recently overhauled regulations to grant authorities the power to allow domestic drugmakers to produce cheap copies of medicines protected by patents.

Emerging markets are on track to make up 28 percent of global pharmaceuticals sales by 2015, up from 12 percent in 2005, according to IMS Health, a healthcare information and services company.

Most sales in emerging markets come from branded generics, which are off-patent drugs priced at a premium to those made by local manufacturers.

The Organisation of Pharmaceutical Producers of India (OPPI), a lobby group for multinational drugmakers in the country, argues that the price of drugs is just one factor in access to healthcare and that the scheme need not be detrimental to manufacturers of branded drugs.

"I think this will hasten overall growth of the pharmaceutical industry, as poor patients who could not afford will now have access to essential medicines," said Tapan Ray, director general of OPPI.

About 600 billion rupees ($11 billion) in drugs are sold each year in India, or 482 billion at wholesale. Drugs covered under the new policy account for about 60 percent of existing sales, or 290 billion rupees at wholesale cost.

The government's annual cost is likely to be lower due to bulk purchasing and because patients at private clinics would still pay for their own drugs. States will pay for 25 percent of the free drugs and the central government will cover the rest.

Under various existing programs, around 250 million people, or less than a quarter of India's population, now receive free medicines, according to the health ministry.

India's new policy, to be implemented by the end of 2012 and rolled out nationwide within two years, is expected to provide 52 percent of the population with free drugs by April 2017, at a cumulative cost of 300 billion rupees ($5.4 billion).

That requires a major funding ramp-up from a deficit-strapped government. The scheme has been granted just 1 billion rupees thus far from central government coffers.

STRICT INSTRUCTIONS

Public doctors will be able to spend 5 percent of the budget, equivalent to around $50 million a year, on drugs outside of the government's list, on branded drugs or on medicines that are not on the list. Beyond that, they can be punished, said Goyal, the health ministry official.

"If doctors are found to be prescribing medicines which are not on the list, or which are branded, then disciplinary action will be initiated," he said.

Free medicine is just one solution to better healthcare in India, where just getting to a state clinic can require a long journey.

Swapnil Yadav, who runs a clinic in Ambegaon, a village 170 km (105 miles) southeast of Mumbai, said India should set up free drug retailers instead of government clinics.

"Patients can approach a private clinic and then get free medicines from government-run medicine shops," he said.

The free generics scheme, which mirrors policies in the states of Tamil Nadu and Rajasthan, is expected to be fully operational by the time voters go to the polls for the 2014 general election, when the populist Congress party will seek a third straight victory.

Indian makers of generics such as Dr Reddy's and Cipla are best placed to benefit.

"The move will please the generics manufacturers who stand to gain substantially in competing for contracts," said KPMG's Stirling.

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Romney, in switch, says Obama healthcare a tax

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Methadone linked to 30 percent of painkiller overdoses

"A drug addict receives his daily dose of methadone. The prescription drug methadone is linked to over 30 percent of painkiller overdose deaths, according to a report released by the Centers for Disease Control (CDC) and Prevention Tuesday. (AFP Photo/Hoang Dinh Nam)" title

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Post-Op Delirium's Toll on Mental Function May Linger: Study

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Health Tip: Bonding With Your Infant

HealthDay – 4 mins 46 secs ago (HealthDay News) -- Developing an intimate relationship with your newborn appears key to your baby's social and mental development, the Nemours Foundation says.

Bonding provides the infant with initial exposure to intimacy and helps foster the infant's self-esteem, the Foundation says.

Here are the Foundation's suggestions for new parents to promote bonding with their infants:

Provide soothing touch and skin-to-skin contact.Engage in eye-to eye contact with baby at close range.Move an object back and forth in front of baby's face.Make lots of faces and gestures for your baby to watch, learn and mimic.Talk to your baby frequently to foster a familiarity with your voice.

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Higher Doses of Vitamin D Prevent Fractures in Older Women

HealthDay – 4 mins 43 secs ago WEDNESDAY, July 4 (HealthDay News) -- In the latest study to look at the effect of vitamin D on fracture risk, Swiss researchers found that taking more than 800 international units (IU) of vitamin D daily could reduce the risk of hip fractures in older women by 30 percent.

"Vitamin D supplementation is effective in fracture reduction, including hip fractures," said study author Dr. Heike Bischoff-Ferrari, from the Center on Aging and Mobility at the University of Zurich and Wald City Hospital, also in Zurich.

"However, dose matters, as we saw this benefit only at the highest intake level of greater than 800 IU per day, and no dose below 792 IU per day reduced fracture risk," she said.

If everyone took more than 800 IU of vitamin D daily, the impact on public health could be enormous because hip fractures are the most severe and frequent fractures among the elderly, according to Bischoff-Ferrari.

Results of the study are published in the July 5 issue of the New England Journal of Medicine.

Vitamin D is important for bone health, according to Dr. Anna Lasak, clinical director of the department of rehabilitation and the women's physical medicine and rehabilitation program at Montefiore Medical Center, in New York City. The body makes vitamin D when exposed to sunlight. Sunscreen blocks this effect.

Vitamin D is also found in fatty fish, eggs and some mushrooms, she said. It's also added to dairy products, some cereals and some breads, according to Lasak. But, she said, it can be difficult, especially for elderly people, to get enough vitamin D from these sources. In addition, elderly people may have digestive issues that can cause their bodies to absorb even less vitamin D.

A number of studies have been done looking at vitamin D and bone health, and the studies have often come up with conflicting findings, with some showing benefits, while others found no benefits. In mid-June, the U.S. Preventive Services Task Force recommended that postmenopausal women should not take low-dose vitamin D supplements (400 IU) because there was no evidence of benefit. The task force, however, said there wasn't yet enough clear evidence on higher doses of vitamin D to make a recommendation one way or the other.

The current study is a pooled analysis of 11 double-blind, randomized controlled trials of vitamin D supplementation with or without calcium compared to a placebo or calcium supplementation alone.

The studies included more than 31,000 people. All of the participants in the studies were over 65, with an average age of 76. Most (91 percent) of the volunteers in the studies were women.

They found that people taking less than 800 IU daily showed no statistically significant drop in fracture risk. However, those taking over 800 IU reduced the risk of hip fracture by 30 percent and the risk of non spine-related fractures by 14 percent, according to the study.

"Our data strongly support a daily vitamin D supplement of 800 IU per day in adults age 65 and older to lower their risk of fracture, including those living at home and those living in nursing homes, including men and women, and the younger and the old," Bischoff-Ferrari said.

Lasak said 800 IU is a safe level of vitamin D intake for just about anyone. But, she said, it's better for older folks to have their vitamin D levels measured first. Some may not need additional vitamin D, but many actually need more than 800 IU a day.

"Most people do have a deficiency," she said. While 800 IU is a safe limit, that may not be enough, she said. No one should exceed levels of 4,000 IU, Lasak added. That's the upper safe limit of this nutrient.

She said it's also important to ensure that you're getting enough calcium. The recommendation is for between 1,000 and 1,200 milligrams (mg) a day, with older people needing more, she said. Lasak recommended getting the bulk of your calcium from foods, rather than a supplement, because some studies have suggested possible harm from higher levels of calcium intake from supplements.

Bischoff-Ferrari said the current analysis also suggested that higher levels of calcium supplementation (more than 1,000 mg) may reduce vitamin D's benefit.

More information

Learn more about vitamin D and bone health from the National Osteoporosis Foundation.

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Health Tip: Encouraging a Picky Eater

HealthDay – 4 mins 42 secs ago (HealthDay News) -- If your child is a picky eater, there's a good chance that it's an early attempt to exercise control, the Academy of Nutrition and Dietetics says.

Here's how you can placate your picky eater while getting him or her to munch on more nutritious offerings:

Serve at least one food that you know that your child loves, but offer it along with other foods that other family members enjoy.Help your child feel more in control by offering two or three choices. Avoid offering too many choices, which can be overwhelming.Let kids participate in preparing, planning, shopping for and cooking meals.Make sure you eat the foods that you're encouraging your child to eat.

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Single-Embryo IVF Cuts Risk to Baby: Study

HealthDay – 4 mins 39 secs ago WEDNESDAY, July 4 (HealthDay News) -- Transplanting just one embryo during assisted reproduction treatments reduces the risk of preventable infant deaths that occur just before or shortly after birth, which is termed perinatal mortality, Australian researchers report.

"The number of embryos transferred per procedure is the major determinant of multiple pregnancy and multiple delivery, which contribute to an elevated risk of preterm birth and low birth weight, and its

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Leave 4th of July Fireworks to Professionals

HealthDay – 4 mins 38 secs ago WEDNESDAY, July 4 (HealthDay News) -- For safety's sake, Americans should avoid using fireworks of any kind this Independence Day, experts say.

Prevent Blindness America urges consumers to attend only authorized public fireworks displays conducted by licensed operators. Individuals should not buy, use or store fireworks, including sparklers, the nonprofit organization added.

Although sparklers are sometimes considered to be safe, they were responsible for 17 percent of the injuries, including 36 percent of those sustained by children under 5 years of age, according to the U.S. Consumer Product Safety Commission (CPSC). Injuries from sparklers and other novelties also made up two out of five emergency room injuries, the CPSC found.

Overall, an estimated 6,200 people went to the emergency room between June 17 and July 17, 2011, for injuries they sustained while using fireworks, according to the CPSC. Their 2011 Fireworks Annual Report noted that children younger than 15 accounted for 26 percent of those injuries.

Prevent Blindness America announced it supports bans on the importation, sale and use of all fireworks and sparklers by non-licensed operators, such as bans established in Delaware, Massachusetts, New Jersey and New York.

Last year alone, there were also more than 1,100 reported eye injuries, according to the CPSC report. To help Americans avoid the emergency room this July 4th, Prevent Blindness America offered the following safety tips:

If there are specks in the eye:

Do not rub the eye.Allow tears to wash out the particles or use an eye wash.Lift the upper eyelid outward and down over the lower lid.If the speck doesn't wash out, see a doctor or visit the emergency room.

If the eye or eyelid is cut or punctured:

Do not rinse the eye with water.Do not try to remove any object stuck in the eye.Cover the eye with a stiff shield, such as the bottom of a paper cup, without applying any pressure.Visit a doctor or an emergency room immediately.

"The 4th of July should be a time when we come together to honor our country by celebrating our great nation safely and responsibly," Hugh Parry, president and CEO of Prevent Blindness America, said in an organization news release. "We hope all Americans have a wonderful holiday with their loved ones, not in the emergency room."

More information

The U.S. National Library of Medicine has more about eye injuries.

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Sleep apnea gets worse in the winter: study

Reuters – 3 hrs ago (Reuters) - Respiration problems in sleep apnea - which causes people to momentarily stop breathing multiple times throughout the night, for seconds to minutes at a time - appear to worsen during the colder months of the year, according to a study from Brazil.

Changes in weight and seasonal allergies can affect sleep apnea, and researchers writing in the journal Chest wanted to see if weather changes might also have an impact.

"More sleep disordered breathing events were recorded in wintertime than in other seasons," wrote study leader Cristiane Maria Cassol from the Universidade Federal do Rio Grande do Sul.

Cassol and her team said it could be due to several causes, including winter-related upper-airway problems that intensify the severity of symptoms and the use of burning wood to heat homes during the winter.

The team utilized data from sleep clinic patients and looked at how many times their rest was disturbed by breaks in breathing. The study included one night of sleep for more than 7,500 patients over a 10-year-period.

Researchers then compared the severity of the patients' apnea to the weather conditions at the time, including humidity, temperature and air pollution.

Patients who came in during colder months had more nighttime breaks in breathing than those who sought treatment during warmer months. During the winter, patients stopped breathing an average of 18 times an hour compared to 15 times an hour during the summer.

Similarly, the sleep clinic was more likely to see the most severe cases - people who stopped breathing more than 30 times an hour - during the colder months.

About 34 percent of patients who came in during cold weather had severe apnea, compared to 28 percent of patients during warmer weather.

The team found that certain weather conditions, such as high atmospheric pressure and humidity and high levels of the air pollutant carbon monoxide - were tied to worse cases of apnea.

But the study could not determine whether it was the weather itself that was responsible for the more severe apneas.

Jerome Dempsey, who studies breathing problems at the University of Wisconsin and wasn't involved in the study, said it makes sense that airway infections and weather could have an effect on sleep apnea, but that the changes across the seasons were small.

"There are so many things that affect sleep apnea, including the decision of when to come visit" a sleep clinic, Dempsey told Reuters Health.

In other words, it might not be the weather but the time of year that makes it more convenient for patients to take the time to seek treatment.

He added that while winter-related conditions such as colds or allergies might intensify sleep apnea, the biggest risk factor is obesity. SOURCE: http://bit.ly/MqNmmE

(Reporting from New York by Kerry Grens at Reuters Health; editing by Elaine Lies and Bob Tourtellotte)

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